Objective: To assess the efficacy of the new, second generation UroLume (American Medical Systems) prostatic stent.
Patients and methods: Forty-seven men with symptomatic and objective evidence of bladder outflow obstruction who were fit for a transurethral resection accepted, as an alternative, the insertion of a new prostatic stent which shortens less than its predecessor.
Results: It was possible to insert the stent into 44 of the 47 men. All patients voided spontaneously following stent insertion. Thirty-three patients had their stent inserted either as a day case or with an overnight stay. Six patients were lost to follow-up and two died. Of the remaining 36 patients 22 have now been followed for 2 years, with a mean obstructive score of 1.6 (range 0-12), a mean irritative score of 2.5 (range 0-10) and a mean peak flow of 16.8 mL/s (range 3-31). Fourteen stents had to be removed; in the majority of cases this was because of stent migration or the development of epithelial hyperplasia within the lumen of the stent.
Conclusion: Because of the development of epithelial hyperplasia and stent migration in approximately one-third of men in this study, a third generation stent has now been developed. Before permanently implanted stents can be recommended for widespread use, the efficacy of new stents should be assessed in specialist units with large numbers of patients and adequate facilities for follow-up.